Pharmacist test-and-treat services: Bridging the gap from certification to practice integration

Florida's House Bill 389 expanded community pharmacists' scope of practice to include testing and treating minor, nonchronic conditions through collaborative practice agreements with physicians. While pharmacist certification training programs have facilitated implementation of these services, limited evidence exists regarding the extent to which certified pharmacists have incorporated test-and-treat services into routine pharmacy practice.

This study evaluated the extent to which certified Florida pharmacists have integrated test-and-treat services into clinical practice.

A cross-sectional electronic survey was conducted among Florida pharmacists who completed state-specific certification to provide test-and-treat services in the Florida Department of Health portal (N=3,379). The survey assessed pharmacists' practice settings, certification pathways, implementation of test-and-treat services, conditions managed, and confidence level in providing clinical activities. Descriptive statistics were used to summarize pharmacist characteristics and service utilization.

A total of 266 responses were recorded (7.9% response rate). Respondents were primarily female (62%), over the age of 47, and employed within large chain community pharmacies. Walgreens was the leading certification provider (44%), followed by the University of Florida (19%) and Walmart (18%). Pharmacists expressed confidence in referring patients and in interpreting point-of-care test results. Implementation of test-and-treat services showed 97% of pharmacists saw fewer than 10 patients weekly. The greatest barriers noted by pharmacists were a lack of reimbursement or unclear billing procedures, a lack of time, and a lack of staff.

Survey data indicate there is a significant gap between test-and-treat certification and clinical use within Florida. Pharmacists feel clinically confident and are well trained to implement test-and-treat clinical services; however, staff shortages, time constraints, and the lack of reimbursement are restricting these services. Future success will depend on consistent revenue and corporate investment in clinical work flows to advance policies necessary to secure insurer reimbursement.